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OBJECTIVE: The purpose of this study was to investigate whether three-dimensional (3D) magnetic resonance imaging could improve diagnostic accuracy for suspected posterior ligamentous complex (PLC) disruption. MATERIALS AND METHODS: We used 20 freshly harvested goat spine samples with 60 segments and intact surrounding soft tissue. The animals were aged 1–1.5 years and consisted of 8 males and 12 females, which were sexually mature but had not reached adult weights. We created a paraspinal contusion model by percutaneously injecting 10 mL saline into each side of the interspinous ligament (ISL). All segments underwent T2-weighted sagittal and coronal short inversion time inversion recovery (STIR) scans as well as coronal and sagittal 3D proton density-weighted spectrally selective inversion recovery (3D-PDW-SPIR) scans acquired at 1.5T. Following scanning, some ISLs were cut and then the segments were re-scanned using the same magnetic resonance (MR) techniques. Two radiologists independently assessed the MR images, and the reliability of ISL tear interpretation was assessed using the kappa coefficient. The chi-square test was used to compare the diagnostic accuracy of images obtained using the different MR techniques. RESULTS: The interobserver reliability for detecting ISL disruption was high for all imaging techniques (0.776–0.949). The sensitivity, specificity, and diagnostic accuracy of the coronal 3D-PDW-SPIR technique for detecting ISL tears were 100, 96.9, and 97.9%, respectively, which were significantly higher than those of the sagittal STIR (p = 0.000), coronal STIR (p = 0.000), and sagittal 3D-PDW-SPIR (p = 0.001) techniques. CONCLUSION: Compared to other MR methods, coronal 3D-PDW-SPIR provides a more accurate diagnosis of ISL disruption. Adding coronal 3D-PDW-SPIR to a routine MR protocol may help to identify PLC disruptions in cases with nearby contusion.
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Adult , Animals , Female , Humans , Male , Contusions , Diagnosis , Goats , Ligaments , Magnetic Resonance Imaging , Models, Animal , Protons , Sensitivity and Specificity , Spine , Tears , Weights and MeasuresABSTRACT
Objective To compare the effect of postoperative analGesia of the continuous femoral nerve block analGesia( CFNB),continuous epidural analGesia( CEA)and intravenous analGesia( CIA)for patients with total knee arthroplasty. Methods The clinical informations of l44 four patients who underwent line unilateral total knee replacement surGery from April 20ll to May 20l2 were retrospective analyzed. AccordinG to the way of postoperative analGesia,the patients were divided into different CFNB Group( n=70 ),CEA Group( n=36 )and CIA Group(n=38). Record the pain score of 24 h,48 h and 72 h after surGery and adverse reaction. Results VAS score of CFNB Group and CEA Group at 24 h and and 48 h after surGery were siGnificantly lower than in CIA Group( P<0. 0l). While there was no siGnificant difference amonG three Groups in term of VAS score at the 72 h after surGery. Adverse reactions of postoperative Gastrointestinal and spiritual nerve symptoms of CFNB Group were siGnificantly lower than in CEA Group and CIA Group( P<0. 0l ). Postoperative catheter related problems of CFNB Group were siGnificantly hiGher than CEA Group and CIA Group( P<0. 05 ). Conclusion AnalGesic effect of CFNB and CEA for after total knee arthroplasty is Good,and better than that of CIA. But CEA and CIA have Greater adverse reactions.
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Objective By detecting the expression of caveolin-1 in osteosarcoma tissues,to explore its possible roles in the occurrence,progress and metastasis of osteosarcoma and its relationship with clinicopathological features.Methods The expression level of caveolin-1 protein in 48 osteosarcoma tissues and 24 normal bone tissues were detected by immunohistochemistry of SP method.Its relationship with clinical and pathological features were also analyzed.Results among the 48 osteosarcomas examined,38 were stained weak or negative for caveolin-1,whereas the strong caveolin-1 staining was observed in all the 24 normal bone tissues.The absorbent optical density value of caveolin-1 protein in osteosarcoma tissues and normal bone tissues were(0.2292 ± 0.0329) and(0.6428 ± 0.0028),respectively.The expression of caveolin-1 in osteosarcoma tissues was significantly lower than that in normal bone tissues (t =21.48,P ＜ 0.01 ).Caveolin-1 protein expression was significant correlated with the pulmonary metastasis of tumors ( t =11.84,P ＜ 0.05 ),but had no correlation with nge,sex,tumor size and pathologic grades.Conclusion The low expression of caveolin-1 may participate in osteosarcoma invasion and metastasis,and may be a new prognostic molecular marker for osteosarcoma and a new therapeutic target for tumor.
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Objective To evaluate the ability of 64-slice spiral CT(64-MSCT) in demonstrating the coronary collateral circulation(CCC).Methods Patients undergoing 64- MSCT coronary angiography with relatively good image quality from August 2005 to April 2007 were entered into the study according to following requirements: patients underwent a traditional coronary artery angiography (CAG) after the coronary CT imaging; the CAG showed there was stenosis greater than 90% in at least one major coronary artery.The CCCs were assessed in CAG by the Rentrop grading, and the CAG served as the gold standard to determine the accuracy of 64-MSCT angiography in detecting collateral circulations.All CCCs were grouped angiographieally into three groups of CC0, CC1 ,and CC2 by Werner collateral collection(CC) grading.In the 64-MSCT coronary angiography imaging, a new grading(MSCT-CC) was used to evaluate CCCs.The consistency between these two grading standards was analyzed by Kappa test.Resalts A total of 97 patients were entered into the study, among whom at least one CCC was found by CAG in 37 patients and at least one CCC was detected by 64-MSCT angiography.Taken the CAG results as the reference standard, the sensitivity and specificity of the 64-MSCT angiography in detecting patients with the CCCs were 89.2% (33/37) and 93.8% (60/64) respectively.The sensitivity of the 64-MSCT angiography detecting the CCCs was 75.8% (47/62). All the CCCs detected by CAG and 64-MSCT angiography were grouped into three groups according to Werner grading: 4 in CC0 group, 24 in CC1 group and 19 in CC2 group.The CCCs were grouped into three groups according to MSCT-CC: 7 in MSCT-CC0 group, 22 in MSCT-CC1 group and 18 in MSCT-CC3 group.The consistency of the two grading criteria was relatively high (Kappa = 0.857, P < 0.01).Conclusion 64-MSCT angiography can accurately evaluate the coronary collateral circulation.
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Objective To compare the image quality and radiation dose between prospective ECG-trigering and retrospective ECG gating technique in coronary artery imaging. Methods 33 patients suspected coronary artery disease were included in this study and divided into experimental group (prospective ECG-triggering coronary artery imaging, heart rate < 65 bpm, 16 patients)and control group (retrospective ECG gating coronary artery imaging, heart rate < 75 bpm, 17 patients). Radiation dose was recorded for statistical analysis. At the same time, image quality was evaluated. Results There were no significant differences in image quality 3.2 msy. Effective dose reduced 76.47 %. Conclusions Prospective ECG gating coronary artery imaging can obtain the similar image quality compared with prospective ECG gating coronary artery imaging but the effective dose reduced 76.47 %. Prospective ECG gating coronary artery imaging has clinical value to peoples who are able to not accept high radiation dose and with low heart rate.
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Objective To evaluate the role of CT imaging in staging of hypopharyngeal and laryngeal carcinoma.Methods 85 patients with hypopharyngeal or laryngeal carcinoma proved by operation were examined contrast-enhanced CT scan.The CT images were analysed by two experienced radiologists who were unknown pathologic results,in combination with the clinical data,the TNM staging of tumors were evaluated,then the results were compared with that of pathology,and Wilcoxon rank sum test was used for statistical analysis.P value less than 0.05 was considered statistically significant.Results The accuracy of the staging of lesions was 70.1% based on clinical data alone,while the clinical informations in combination with CT,the accuracy reached 87.1%,that was of significant statistically(P=0.001).Conclusion CT imaging is useful in staging of hypopharyngeal and laryngeal carcinoma,especially when it is combined with clinical data.
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Objective To investigate CT value in diagnosing hypopharyngeal and laryngeal disease.Methods The clinical data and CT images of 76 patients with hypopharyngeal and laryngeal tumors and tumor-like lesions were retrospectively reviewed.There were malignant lesions in 66 cases and benign lesions in 10 cases.CT findings in these patients were evaluated and correlated with surgical and pathologic findings.First,we used a CT features were qualitatively analysed using logistic regression model for predicting the lesion to be malignant or benign.Then,two experienced radiologists who were unknown the results of final diagnosis of these patients,retrospectively analyzed all CT images and made their diagnosis.Finally,CT images of 10 benign and 10 randomly selected malignant patients were reviewed by the other two experienced radiologists,who known the component ratio of the cases and unknown the final results.Interobserver agreement of the two reviewers was assessed by calculation of Kappa value for their diagnosis.Results The logistic regression model revealed that the location of lesion and the surrounding structure infiltrated by the tumor were the only significant factors for predicting the malignancy.Of the two factors,the surrounding structure infiltrated by the tumor had the accuracy of 55% with sensitivity 53% and specificity 80%.When most of the cases were malignant(66/76),there was a moderate interobserver agreement for the two radiologists in diagnosis of the diseases.When the malignant and benign cases were equal,there was a poor interobserver agreement(Kappa=0.20) for the two reviewers,and the diagnostic accuracy was slightly higher than the rate by random selection.Conclusion It is difficult to use the CT features in qualifying the hypopharyngeal and laryngeal diseases.
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Objective To explore if only single-phase enhanced CT can be used for pre-treatment staging of hypopharyngeal and laryngeal carcinoma.Methods The double phase enhanced CT images in 47 cases with hypopharyngeal or alryngeal carcinoma were retrospectively studied.CT number of tumor,vocal cord and sternocleidomastoideus muscle was measured on plain,early-phase,and late-phase enhanced CT scan,and the definition of tumor margins, small-vessel artifacts and mucous artifacts was recorded. The effective radiation dose of patients was calculated for 16DCT and HCT according to dose-length product (DLP).Results There was no significant difference between the density of tumor and the vocal cord on plain CT scan. There were more mucous artifacts and/or small-vessel artifacts in early-phase enhanced CT images. The definition of tumor margin in late-phase enhanced CT image was better than or almost same as that in early-phase enhanced CT image. The effective radiation dose with 16DCT was 1.5 times to that with HCT at the same scanning range. Conclusion Only late-phase enhanced CT imaging is recommended to be performed for the staging of hypopharyngeal or laryngeal carcinoma, and it will reduce the effective radiation dose received by patients.